Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LASER FIBER SLIMLINE 550

Facility

$3,215.00

Hospital Charge Code	270670032
Hospital Revenue Code	272
Min. Negotiated Rate	$482.25
Max. Negotiated Rate	$482.25
Rate for Payer: Qualcare PPO/HMO/WC	$482.25

LASER FIBR HOLM MC HFO200DSSMS

Facility

$1,000.00

Hospital Charge Code	270632539
Hospital Revenue Code	272
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

LASER FIBR HOLM MC HFO200DSSMS

Facility

$1,000.00

Hospital Charge Code	270632539
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

LASER GREENLIGHT RENTAL

Facility

$4,250.00

Hospital Charge Code	270645490
Hospital Revenue Code	272
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$637.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

LASER GREENLIGHT RENTAL

Facility

$4,250.00

Hospital Charge Code	270645490
Hospital Revenue Code	272
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,105.00
Rate for Payer: Oxford Commercial	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Commercial	$850.00
Rate for Payer: UnitedHealthcare Community & State	$134.30
Rate for Payer: Wellpoint Medicaid Managed Care	$120.70

LASER PRO TOUCH

Facility

$4,750.00

Hospital Charge Code	270662160
Hospital Revenue Code	272
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$712.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

LASER PRO TOUCH

Facility

$4,750.00

Hospital Charge Code	270662160
Hospital Revenue Code	272
Min. Negotiated Rate	$134.90
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Oxford Commercial	$950.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Commercial	$950.00
Rate for Payer: UnitedHealthcare Community & State	$150.10
Rate for Payer: Wellpoint Medicaid Managed Care	$134.90

LASER VAPOZATION OF PROSTATE

Facility

$39,246.20

Service Code	HCPCS 52648
Hospital Charge Code	16000649
Hospital Revenue Code	360
Min. Negotiated Rate	$5,886.93
Max. Negotiated Rate	$5,886.93
Rate for Payer: Qualcare PPO/HMO/WC	$5,886.93

LASER VAPOZATION OF PROSTATE

Facility

$39,246.20

Service Code	HCPCS 52648
Hospital Charge Code	16000649
Hospital Revenue Code	360
Min. Negotiated Rate	$1,114.59
Max. Negotiated Rate	$23,107.03
Rate for Payer: Aetna Commercial	$17,326.29
Rate for Payer: Aetna Medicare Advantage	$20,638.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,107.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,107.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,369.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,107.03
Rate for Payer: Cigna Commercial	$12,768.54
Rate for Payer: Cigna Medicare Advantage	$6,369.96
Rate for Payer: Clover Medicare Advantage	$6,051.46
Rate for Payer: EmblemHealth Commercial	$19,109.88
Rate for Payer: Humana Medicare Advantage	$6,561.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,369.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,204.01
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,886.93
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$1,240.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,369.96
Rate for Payer: Wellcare Medicare Advantage	$6,369.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1,114.59

LASSO QUICKPASS CURVE LEFT 45

Facility

$1,145.00

Hospital Charge Code	270667328
Hospital Revenue Code	270
Min. Negotiated Rate	$171.75
Max. Negotiated Rate	$171.75
Rate for Payer: Qualcare PPO/HMO/WC	$171.75

LASSO QUICKPASS CURVE LEFT 45

Facility

$1,145.00

Hospital Charge Code	270667328
Hospital Revenue Code	270
Min. Negotiated Rate	$32.52
Max. Negotiated Rate	$572.50
Rate for Payer: Aetna Commercial	$435.10
Rate for Payer: Aetna Medicare Advantage	$343.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$291.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$291.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$291.98
Rate for Payer: Cigna Commercial	$572.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$297.70
Rate for Payer: Oxford Commercial	$229.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.75
Rate for Payer: UnitedHealthcare Commercial	$229.00
Rate for Payer: UnitedHealthcare Community & State	$36.18
Rate for Payer: Wellpoint Medicaid Managed Care	$32.52

LASSO QUICKPASS RIGHT 25 DEG

Facility

$1,145.00

Hospital Charge Code	270667327
Hospital Revenue Code	270
Min. Negotiated Rate	$171.75
Max. Negotiated Rate	$171.75
Rate for Payer: Qualcare PPO/HMO/WC	$171.75

LASSO QUICKPASS RIGHT 25 DEG

Facility

$1,145.00

Hospital Charge Code	270667327
Hospital Revenue Code	270
Min. Negotiated Rate	$32.52
Max. Negotiated Rate	$572.50
Rate for Payer: Aetna Commercial	$435.10
Rate for Payer: Aetna Medicare Advantage	$343.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$291.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$291.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$291.98
Rate for Payer: Cigna Commercial	$572.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$297.70
Rate for Payer: Oxford Commercial	$229.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.75
Rate for Payer: UnitedHealthcare Commercial	$229.00
Rate for Payer: UnitedHealthcare Community & State	$36.18
Rate for Payer: Wellpoint Medicaid Managed Care	$32.52

LATANOPROST 2.5 ML SOL

Facility

$1,043.59

Service Code	NDC 13830304
Hospital Charge Code	60628089
Hospital Revenue Code	250
Min. Negotiated Rate	$156.54
Max. Negotiated Rate	$156.54
Rate for Payer: Qualcare PPO/HMO/WC	$156.54

LATANOPROST 2.5 ML SOL

Facility

$1,043.59

Service Code	NDC 13830304
Hospital Charge Code	60628089
Hospital Revenue Code	250
Min. Negotiated Rate	$29.64
Max. Negotiated Rate	$521.79
Rate for Payer: Aetna Commercial	$396.56
Rate for Payer: Aetna Medicare Advantage	$313.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$266.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$266.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$266.12
Rate for Payer: Cigna Commercial	$521.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.33
Rate for Payer: Oxford Commercial	$208.72
Rate for Payer: Qualcare PPO/HMO/WC	$156.54
Rate for Payer: UnitedHealthcare Commercial	$208.72
Rate for Payer: UnitedHealthcare Community & State	$32.98
Rate for Payer: Wellpoint Medicaid Managed Care	$29.64

LATERAL ENTRY FEMOR NAIL(10MM)

Facility

$6,645.00

Hospital Charge Code	270656684
Hospital Revenue Code	278
Min. Negotiated Rate	$996.75
Max. Negotiated Rate	$1,608.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,329.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,608.09
Rate for Payer: Qualcare PPO/HMO/WC	$996.75

LATERAL ENTRY FEMOR NAIL(10MM)

Facility

$6,645.00

Hospital Charge Code	270656684
Hospital Revenue Code	278
Min. Negotiated Rate	$188.72
Max. Negotiated Rate	$3,322.50
Rate for Payer: Aetna Commercial	$2,525.10
Rate for Payer: Aetna Medicare Advantage	$1,993.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,694.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,694.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,329.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,694.47
Rate for Payer: Cigna Commercial	$3,322.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,608.09
Rate for Payer: Qualcare PPO/HMO/WC	$996.75
Rate for Payer: UnitedHealthcare Community & State	$209.98
Rate for Payer: Wellpoint Medicaid Managed Care	$188.72

LATERAL KWIRE

Facility

$1,125.00

Hospital Charge Code	270704025
Hospital Revenue Code	272
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

LATERAL KWIRE

Facility

$1,125.00

Hospital Charge Code	270704025
Hospital Revenue Code	272
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Commercial	$225.00
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

LATERAL PATIENT POSITIONER

Facility

$3,250.00

Hospital Charge Code	270703548
Hospital Revenue Code	272
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

LATERAL PATIENT POSITIONER

Facility

$3,250.00

Hospital Charge Code	270703548
Hospital Revenue Code	272
Min. Negotiated Rate	$92.30
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$845.00
Rate for Payer: Oxford Commercial	$650.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Commercial	$650.00
Rate for Payer: UnitedHealthcare Community & State	$102.70
Rate for Payer: Wellpoint Medicaid Managed Care	$92.30

LATERAL PLATE 30MM

Facility

$16,341.90

Hospital Charge Code	270702310
Hospital Revenue Code	278
Min. Negotiated Rate	$464.11
Max. Negotiated Rate	$8,170.95
Rate for Payer: Aetna Commercial	$6,209.92
Rate for Payer: Aetna Medicare Advantage	$4,902.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,167.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,167.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,268.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,167.18
Rate for Payer: Cigna Commercial	$8,170.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,954.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,451.28
Rate for Payer: UnitedHealthcare Community & State	$516.40
Rate for Payer: Wellpoint Medicaid Managed Care	$464.11

LATERAL PLATE 30MM

Facility

$16,341.90

Hospital Charge Code	270702310
Hospital Revenue Code	278
Min. Negotiated Rate	$2,451.28
Max. Negotiated Rate	$3,954.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,268.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,954.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,451.28

LAT INTERBODY 18X40X10MM 6 DEG

Facility

$21,000.00

Hospital Charge Code	270702451
Hospital Revenue Code	278
Min. Negotiated Rate	$3,150.00
Max. Negotiated Rate	$5,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,082.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,150.00

LAT INTERBODY 18X40X10MM 6 DEG

Facility

$21,000.00

Hospital Charge Code	270702451
Hospital Revenue Code	278
Min. Negotiated Rate	$596.40
Max. Negotiated Rate	$10,500.00
Rate for Payer: Aetna Commercial	$7,980.00
Rate for Payer: Aetna Medicare Advantage	$6,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,355.00
Rate for Payer: Cigna Commercial	$10,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,082.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,150.00
Rate for Payer: UnitedHealthcare Community & State	$663.60
Rate for Payer: Wellpoint Medicaid Managed Care	$596.40

Know your out-of-pocket cost for care.

All Charges